One more question about appeals

I have my appeal letter all ready to go. Im still waiting on a set of records from my former PCP. I requested them two months ago and asked her to send them to me within 30 days for an insurance appeal. She has yet to comply with my request (Ive sent two already). I believe her records will have information regarding my diet attempts and lifestyle changes (unless she didn't document any of it and then they won't help me much anyway). Should I send my appeal without her records, or give her more time to send them to me? My letter is very compelling, I think, and I have photos of myself and of the skin condition I have as a result of too much insulin in my system, but I just don't know if that will be enough. What would you do?

Colleen, If I where you I would march into that office and tell them if they didn't do this asap you will have your lawyer contact them!!! That is bunk those are YOUR records. There is no reason it should take them this long! Go gett'um girl!!!

You are being too nice! How long do you have to appeal anyway? I agree with toni, you go in there and demand them. If not, call your insurance and tell them the pcp isn't handing it over and see what they say. My records had no diet attempts in it, and i let them know in the in-person-appeal that it was because the doc didn't write them down, that it wasn't my fault. You have to be strong and fight for this, don't let them make you miss out. If it were me, i'd have been calling every single day for the last month and drove them nuts! Hugs Linda

Yes, I suspect that I have been too nice about it, but in my defense I have had other things going on that have kept me preoccupied and put this on the back burner temporarily. Now that the other stuff Ive been dealing with is winding down, i can get back on top of my appeal issue. As for how long, you have 2 years from your initial denial to appeal. I was denied Jan 20, so I have until Jan 20, 2008 to send in my appeal. Once I send it in, if I am denied again, I only have 30 days to appeal for a level II, which is what *Kim* just went through yesterday. I would like to get my appeal submitted and get moving on this. If it takes 2 months to get from denial to inperson, then Id like to get there by June at the latest.